NOTESome symptoms of heat stress are similar tosymptoms of nerve agent poisoning.The rapid action of nerve agents calls for immediateadministration of the antidotes atropine andpralidoxime chloride (2-PAM C1). Atropine acts to dryup secretions in the respiratory tract and to stimulate thecentral respiratory functions, and 2-PAM C1simultaneously relieves muscle paralysis, especially inthe respiratory tract. Both antidotes are self-injectedinto the lateral thigh muscle by the use of automaticinjectors.Blister AgentsBlister agents act on the eyes, mucous membranes,lungs, and skin. Blister agents include mustard vaporsand mustard liquids. Mustards burn and blister the skinthey contact, damage the respiratory tract when inhaled,and cause vomiting and diarrhea when absorbed. Thed eg r e e o f d a m a g e d e p e n d s o n t h e t y p e a n dconcentration of the agent, the weather, the amount ofactivity of the individual, and amount of exposure time.Blister agents are effective even in small quantities andproduce both immediate and delayed injuries.Mustard vapors burn any area of the skin; but, theburn is most severe in moist areas, such as the neck,genitals, groin, armpits, bends of knees, and elbows.Redness of the skin follows in 1/2 to 36 hours afterexposure. This condition may be accompanied byintense itching, and blisters may then appear. Stiffness,throbbing pain, and swelling may also occur.A few hours after breathing the mustard vapor, avictim experiences irritation of the throat, hoarseness,and coughing. After severe exposure, the lining of therespiratory system swells and interferes with breathing.Frequently, pneumonia develops.If the whole body is exposed to mustard vapor, thebody goes into a state of shock. This reaction isaccompanied by nausea and vomiting.Personnel who suspect contamination of their eyesor face must seek overhead shelter and flush the eyeswith potable (drinkable) water from a canteen orshower. Mild exposure to skin can be treated byapplying calamine lotion or topical steroid creams. Allblisters should be opened, drained, and cleansed withtap or saline water. Any exposure to mustards requiremedical care by a corpsman or medical personnel.Blood AgentsBlood agents inhibit the action of an enzymeresponsible for transferring oxygen from the blood tothe cells of the body. Thus the cells become starved foroxygen. Inhalation is the usual route of entry for bloodagents.The symptoms produced by blood agents depend onthe concentration of the agent and the duration (lengthof time) of the exposure. Typically, either death occursrapidly or recovery takes place within a few minutesafter removal of the victim from the toxic atmosphere.High concentrations of blood agent cause laboredbreathing within a few seconds, violent convulsions,followed by cessation (stoppage) of breathingcompletely. Finally, the heart stops only a few minutesafter initial exposure. The symptoms of exposure toblood agents are shown in the following chart:13-4Student Notes:INITIAL SYMPTOMS ADVANCED SYMPTOMSIncreased respirationHeadacheGiddinessDizzinessIncreased pulse rateRed, flushed skinConvulsionsComaDeath
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